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Whether subjective memory complaints in the absence of objective memory decline can predict future dementia has been investigated only in highly selected clinical and volunteer cohorts. Our study examines this question in a subsample of AMSTEL (Amsterdam Study of the Elderly), a longitudinal population study on cognitive decline and dementia. Subjects (aged 65 to 84 years; n = 357) without dementia or other psychiatric disorders at baseline were followed for 3 years. After this interval, 16 of 203 re-examined patients developed a dementia. Logistic regression analyses indicated that memory complaints at baseline contributed a small but significant amount of diagnostic information. However, the most powerful predictor of future dementia was deficient memory performance. We conclude that subjective memory complaints may predict dementia within 3 years, particularly when there are objective signs of memory deterioration.

Simple questions about memory function are related to memory performance in nondepressed, nondemented community-dwelling older people. Subjective memory complaints may be a promising indicator of memory impairment that signals the need for follow-up.

We examined the effects of selected health conditions and sensory functions, socioeconomic status, age, and education on cognitive functioning in 3,974 community-dwelling individuals aged 65-84 years. Logistic regression analysis was used to examine the independent and joint effects of these variables on borderline (Mini-Mental State Exam [MMSE] of 22-25) and poor (MMSE of < or = 21) functioning relative to adequate functioning (MMSE of 26-30). The effect of age and of education on MMSE performance was relatively stable, even after adjusting for age- and education-related health conditions and sensory impairments that also influenced level of cognitive functioning. These conditions included poor vision, Parkinson's disease, diabetes, depression, stroke (in 65-74-year-olds), and low socioeconomic status (in 75-84-year-olds). Education did not modify the effect of these variables on MMSE performance. Additional studies elucidating further the mechanisms that relate these sociodemographic factors to cognitive performance are warranted, as are studies of the relationship between these factors and the incidence of cognitive impairment.

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